| NPI | 1487471124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN CARLISLE Administrator 623-693-2198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-09-24 |
| Last Update Date | 2024-09-24 |